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HomeMy WebLinkAbout19524-z J FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22629 Date SEPTEMBER 29, 1993 THIS CERTIFIES that the building NEW DWELLING Location of Property 11405 MAIN ROAD EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 31 Block 4 Lot 32 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 14, 1990 pursuant to which Building Permit No. 19524-Z dated NOVEMBER 19, 1990 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED DECK AS APPLIED FOR The certificate is issued to RONALD EDEEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-49-SEPT. 21, 1993 UNDERWRITERS CERTIFICATE NO. N-264064 - JANUARY 22 1993 PLUMBERS CERTIFICATION DATED SEPT. 14, 1992-ARTHUR TUTHILL Bu lding Inspector Rev. 1/81 FORM NO. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) W 19524 Z Date Permission is hereby granted to-- � ......... ................... ©k... .............................................. to ..' X.....R4.....C.Vm ..�! ........ ...� - ... . ..QH..... ....................................................................................1............................................................................ at premises located at ..1I S�0 5 M.Q".^. 3........................Z-. .MrS t+.. ......... ................................................................................................................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section ......Q.W........ Block ......gi:4-i........ Lot No. ..,�, -............ pursuant to application dated .....( .0 76l^' ?. ......4.......... 19.�1.�1, and approved by the Building Inspector. Fee $....$2.6.t....l.r.ca ..... .... . ................................ .. Bui ng Inspector Rev. 6130180 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT JAN TOWN HALL 765-1802 'Uo- APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typeweiter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. a 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the • reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100,00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. .//�Q ,*- . . . ' Rcl . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. . 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . .vl� . . . . . .Block. . . . . ./� . . . . . . . . .. . . . . . . . . . . . . . . Subdivision. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit Date Of Permit. A/Pd.//*?.-/.'?4&).AppIicant. . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . ... . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . Fee Submitted: $ . . . . . . . . . . . . . . . . . . . rt g,-?/ I . . . . . . . . . . . . . . . . . . . . . . . . NT a�'A 1, 611 W7:�� cs�FF GLA•C TEL. 765-1802 TORN OF SOi(JTHOd m OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 0 ce i �r TOWN HALL SOUTHOLD,N.Y. 11971 C E R T I F I C A T I O N Building Permit No. I' ,c Z Owner 0NA �.J- (please print) Plumber 8 �e',TH U VL' TUB la ILL (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead, C At (plumber' s signature) Sw�oo n to before_ me this =.L__da YY 19�, Notary Pu lil�i' c�- �lotary Public, County ELOISE LMNER Husem �ry�8qN o1New York CMAd 73 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1. 1195112 BUREAU OF ELECTRICITY F— 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date JANDARY 22,1993 Application No.on file 76024€;92/92 A 264064 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of RONALD MEN, 1100 "N 25, MT NARION , N,Y. in thefollowing location; © Basement ® lst Ft. 0 2nd Ft. ATTIC/OUT Section Block Lot wasexaminedon JANIIARY 05 ,1.993 andfound tobein compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS ISHWA OVENS DSHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT, K W AMT K.W AMT. K W, AMi K.W AMT. HP 30 h0 30 71, 11 I.14 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H,P. GAS H.P AMT NO. A.W G AMT. AMP. AMT AMPS TRANS. AMT H.P NO.ST SYSTEMS FEET AMT. WATTS 4 F 2 SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP, TYPE METER I. 0 PW 1 q 3W 39 3W 3,e 4W NO OF CC COND. A.W,G. NO OF NbLEG A W',G NO.OF NEUTRALS A.W a EQUIP. PER 0 OF CC COND, OF HI LEG OF NEUTRAL 1 200 t8 1 A 1 4/0 t 2/0 OTHER APPARATUS: HOT0R811,-1..0 1f.IT 1, It if.11. G.l2.C.t. -7 9ROK61 0ETECTOR: -1 9At.b] & LdiDEMANN TNCIJ,uAG 14TC.#3G35-E B P,O. BON .38 GREENFOINT, NY. , 11944 GENERAL MANAGER E 12 Per �..._. ...-- This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. INSPECTORS Victor Lessard .,1 ffllt Principal Building Inspector T Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector o F 'i,, ni> -4 v� . ,,,r t,..,.Yr Thomas Fisher' ..^;r z 'q� Southold Town Hall Building Inspector O y+ r, P.O.Box 1179,53095 Main Road Gar Fish i ~ Southold, New York 11971 Y Building Inspector x Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD NOVEMBER 13, 1992 RONALD h BARBARA EDEEN BOX 335 EAST MARION, NY 11939 RE: PREMISES @ 11405 MAIN ROAD, EAST MARION, NY To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XXX An application for Certificate of Occupancy is not on file. (Enclosed) XXX No Underwriters Certificate on file. XXX The check is 1QMU0WKWnot on file. )$25.00 XXX No Health Department Approval on file. No final inspection has been made. XXX No Plumber Solder Certificate on file. (All permits involving Plumbing being issued after April 1, 1984) . BUILDING PERMIT # 19524-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ELD It:SPECTION 11DATE COMMENTS � vl FOUIJDATION ( 1st ) 0.1 FOUNDATIOtJ ( 2nd 2 . o ROUGH FRAME & Q �t PLUMBING H J » 3 . x m m IIJSULATIOPJ PER N . Y. H STATE ENERGY CODE 4 . y . FINAL o z„ ADDITIONAL COMMENTS : a � r 0 H o ^A z N m � . A O 0 • c7 i m �— -o H w January 6 , 1993 Mr. Ronald J. Edeen P.O. Box 335 East Marion, N.Y. 11939 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (outdated/not on file. )$25.00 XXX No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 19524-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. .. _ 'i{ •;<ti'fi.•]i'.:s_i's':}„yJq��S"If �a Ia .� �., 1pvr �r,�r - - •:3 �r`;'�• •-�; �p �_«. •� '��'�� ":mot {-. �i.•7"r - - --4=.p1yL a a. C - .Q •'y' '. 0.4 jI. ''#:6:c Y A�A Wee .y., w....._ :v 9.els In I cJ uj CO!XI2. FOUN DA L-4 WF-LL t kF-55 FOOL -TEST HOLE WELL • 'IV 466 iE PEPEQ TO VIEA" SEA LE`,,-F-L. .--MAPAM0,40ED-JAW.24d99J M-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING V,4-F(NAL REMARKS: DATE T/ INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ I FOUNDATION 1ST [ I ROUGH PLBG. [ ) FOUNDATION 2ND [INSULATION [ ] FRAMING [ ] FINAL REMARKS: e fL � rlr low DATE ` ' �,• INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ � FO DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL REMARKS: ll;�� _ DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ) FOUNDATION 1ST [CIR UGH PLBG. FOUNDATION 2ND [ ) INSULATION [ ) FRAMING [ ) FINAL REMARKS: AOtLl DATE INSPECTOR 5 A { COUNTY OF SUFFOLK 9 PATRICK G. HALPIN SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES DAVID HARRIS, M.D., M.P.H. COMMISSIONER FACT SHEET LEAD IN DRINKING WATER SUPPLIES Sources of Lead Concentrations in Drinking Water Systems Use of lead solder in new plumbing or in plumbing modifications to existing water supply piping. Lead is not a naturally occurring element in Long Island groundwater. Occurrences Lead is present in drinking water as a product of corrosion. The natural corrosiveness of Long Island groundwaters contributes to this process. Most public water supplies in Suffolk provide chemical treatment to increase the water's natural pH, and minimize corrosion products, but no amount of treatment can produce a totally non-corrosive water. Studies indicate that after prolonged periods of water non-use, lead concentrations can be found in excess of Drinking Water Standards.This problem appears to be limited to newly installed internal water piping systems, or recently modified systems, in which lead-based solder is used. Lead is rarely detected in routine water supply surveillance.This fact is seen as indicating that, at a particular location plumbed with lead solder,this problem will diminish with time.The New York State Health Department concurs with this evaluation. Health Considerations Lead is a compound which is accumulated in the body.Human intake can be expected to occur through many environmental sources, including water. Recommended Action In order to minimize lead occurences, the following steps are recommended: Particularly in new or recently modified plumbing systems, users should be encouraged to flush the waterline for a period of at least two minutes prior to consumptive water use. This is particularly necessary after prolonged water non-use, such as the overnight period. WWM-050 June 1985 Page 1 of 2 Rev. January 1989 COUNTY CENTER SEE REVERSE SIDE FOR INSTRUCTIONS FOR FINAL APPROVAL RIVERHEAD, N.V. 11901 19-1115a..2189pe INSTRUCTIONS FOR FINAL APPROVAL OF CONSTRUCTED SYSTEMS It is the applicant's responsibility to call the Department to arrange inspections of the septic system and water supply facilities prior to backfilling.This includes inspections of the soil excavation for the septic system and inspections of the water supply well, well lateral,l,public water supply line, septic system and piping. Following satisfactory construction and inspections: 1. The applicant must submit 4 prints of a survey (up to and including 11"x17"), by a licensed surveyor, of the subject property showing the!llfollowing: a. the lot location and dimensions; b. the lot number(s) and the, name of the subdivision, if applicable; c, the final elevations of the;lot; d. the exact location of the private well,if applicable(give at least 2 dimensions measured from the corners of the building); e. the exact location of the public water service line, if applicable; f. the exact location of the septic tank and leaching pool(s),if applicable. Give 2 dimensions from the building corners to the centers of the septic tank and each leaching pool; g. the exact location of the ;sewer line from the dwelling to the street, if applicable; and h. have a clear area at least 3"x5" for the Department's approval stamp. 2. The applicant must submit a certificate from the sewage disposal system installer attesting thatthe system has been installed according to the criteria of the Suffolk County Department of Health, when applicable. 3. The applicant must submit a well water analysis and well driller's certificate,when applicable.If the well or water quality does not conform to standards, proof of corrective measures will be required. 4. In those cases where public sewers are utilized for the dwelling,the applicant is also to submit one(1)copy of the sewer line inspection approval forthe public sewer district.In districts operated by Suffolk County,two(2)copies for Form S-9, duly executediby the Suffolk County Department of Public Works, are required. 5. In those cases in which the installation and connection of the public water service line have not been inspected by the Department of Health', a tap letter from the appropriate water company is required. PLEASE DOTE: HEALTH DEPARTMENT REFERENCE NUMBER MUST BE ON ALL CORRESPONDENCE OR DOCUMENTS SUBMITTED. PHOTOCOPIES OF DOCUMENTS WILL NOT BE ACCEPTED. PLEASE SUBMIT ALL NECESSARY FINAL PAPERS AT THE SAME TIME. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES \ ;'BUREAU OF WASTEWATER MANAGEMENT SUFFOLK COUNTY CENTER RIVERHEAD, NEW YORK 11901 WWM-050 June 1985 Page 2 of 2 Rev. January 1989 1e.1115b..21e9p. NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE PART 6 WORKSHEET THERMAL RATING METHOD ONE- AND TWO-FAMILY BUILDINGS BUILDING i�"� ��, �� � GROSS FLOOR AREA ADDRESS NUMBER OF STORIES DEGREE DAYS C L, CONTRACTOR, ARCHITECT OR ENGINEER NM (11Q, V-�7- 1 R\�-j tad -,x- ►zG . TELEPHONE r— If the building does not meet the following pre—qualifying conditions, Part 6 of the Energy Code may not be used. YES NO Building is one— or two—family residential . Building is detached. Building is less than 5,000 gross square feet. Building is three stories or less in height. Entrance doors have a storm door or certified U value of .40 or less. Glazing area/gross wall area is equal to or less than: 24% if 5,000 degree days ��< 23% if 6,000 degree days 20% if 7,000 degree days 18% if 8,000 degree days 16% if 9,000 degree days If all of the above conditions are not met, either PART 3, PART 4 or PART 5 of the Energy Code must be used. 41 � a DIRECTIONS: For each component of the proposed building design enter the design information requested such as Areas, "U" or "R" Values. Additional lines are provided for designs with more than one component construction type,. Obtain thermal ratings for each item by consulting the appropriate Tables. A. ROOF/CEI4ING Obtain Thermal Ratings from Table 6-1 , 6-2, 6-1E or 6-2E depending upon degree days and heating type. L Area: f' U—Value: OZ r Square' Ft. herma Rating Area: U—Valuer Q 5quare- Ft. Thermal Rating B. NET WALLS Obtain Thermal Ratings from Table 6-1 or 6=1E depending upon heating type. Area: U—Value: ©�3` 1 4 '1 Square Ft. Thermal Rating Area: �3 7 2=4 U—Value: 0 Square Ft. Thermal Rating I Note: Net Will Area = Gross Wall Area minus Basement/Cellar Walls, Glazing Areas and Door Areas. C. GLAZINGI Obtain Thermal Ratings from Table 6-3 or +i 6-3E depending upon heating type. WINDOWS 3 �, { Area of Glazing: 2 'Z` U—Value: Square Ft. Thermal Rating Area of Glazing. U—Value: Square Ft. Thermal Rating SKYLIGHTS Area of Glazing: U—Value: Square Ft. Thermal Rating i 42 y Dl . FLOORS Obtain Thermal Ratings from Table 6-1, / 11� 6-1E or 6-4E depending upon degree -days q and heating type. Floor Area:/ r � �D U—VaIue:. , fi C Q Sq. Ft. Thermal Rating D2. BASEMENT/CELLAR WALLS Obtain Thermal Ratings from Table 6-4, 6-5, 6-6 or 6-5E depending upon degree days and , heating type. . Wall Perimeter: I Linear`Feet Exposure Above Grade: UT--? �., Feet U—Value of Wall : Depth of Wall U—Value Below Grade: Inches Thermal Rating Note: Use the above grade U—Value of the wall. The Thermal Rating Tables have been designed to take into account the insulating effect of the earth. D3. SLAB INSULATION Obtain Thermal Ratings from Table 6-7 or 6-6E depending upon heating type. Slab Perimeter: Linear Feet Insulation R—Value: 1 r '� ' Thermal Rating 43 E. INFILTRATION CONTROL Obtain Thermal Ratings from Table 6-8 or 6-7E depending upon heating type. If the building does not meet the following conditions, enter NA (Not Applicable) for Thermal Rating. 1 YES NO _ All windows have an air leakage ratelof 0.35 cfm or less per linear foot of operable sash crack; _ All net wall areas have an infiltration barrier; —' and A heat recovery ventilator, which transfers heat between the outgoing airstream and the airstream entering from the outside, is installed. � Conditioned Floor Area: �• (Shall not include Square Ft, hermal 1 Ratin9 basement/cellar floor area) I ' F. SOUTH FACING GLAZING Obtain Thermal Ratings 'from Table 6-9 or 6-8E depending uponlheating type. If the building does not meet the following conditions, enter NA (Not Applicable) for Thermal Rating. YES NO The building is no less than 1,250 square feet in conditioned floor area; _ At least 45 percent of all glazing faces within 30 degrees of true south; i _ All glazed areas in buildings are no more than U(glazing) = 0. 58; South facing glazed areas are free 'of any site obstructions during the heating season; and _ An area of four—inch thick concrete or masonry is exposed to direct sunlight from south facing glazing. The area of this concrete or masonry shall be no less than three times the area of south facing glazing. Conditioned South Glass/Total Glass: 7 Floor Area: Square Ft. (See Above) Glass Area/Gross Wall Area: % Thermal Rating 44 SUMMARY OF TOTAL THERMAL RATING If the Total Thermal Rating is zero (0) or greater, the proposed design for the building envelope complies with the Energy Code. THERMAL TABLE AREA U—VALUE RATING USED A. ROOF/CEILINGd B. NET WALLS r 07 � O 71� C. GLAZING L � Window ZL- 1 �3 eF C9 6 Window��wFc� �— Skylights D1 . FLOORS D2. BASEMENT/CELLAR WALLS Wall Perimeter Feet Exposure Above Grade Feet Wall U—Value Depth of Wall U—Value Below Grade Inches D3. SLAB INSULATION Slab Perimeter Feet Insulation R—Value E. INFILTRATION CONTROL Conditioned Floor Area Sq. Ft. F. SOUTH FACING GLAZING South Glass/Total Glass Percent Gl . Area/Gross Wall Area Percent — Conditioned Floor Area Sq. Ft. TOTAL THERMAL RATING r .41 Q °:i7 9•s hs' • t> sf 234OQ,.Fots Gp 7'ME S� 45 RS qt t; ,} ' w 1 _` y3 . { a„�}'yk„1, /,l{((��...��'yn3 ,Ck'(,t •i'+ ,;t'j,'.`. } ;. {" a `•`+M / r, a '}y,�iah'}*�n,.t b is ^/i3 �: # kri+�',a 'la`�. «! �' , je s A- < ���� • '{°Y / I�f�$�.ij '� f ASi� rr+ e sw �Y'�p�' r st Yl 1 y ,„§' � ✓$r� ff''^^��*��*3 � � Y6� ��' f F§ s I l l ,n �. e `F� �'`,`' +!q� l AA n 4s a'# �'1114,16 r kt: Yyf <x, 5 �' (it} �?§n �L < s r r -• w F k e!` rr M-a �n A �. r ftr o2g+ k 4�+�• r+ )i ir' �� +� a � t!Z xy SRi y /, f ' krk�A �tYy was'e3 - i § s� §. ; �+te>. . r,t is fox n , �a 9 'v M rW V", r���x`��" t`3�C kn °x �e(� fS4 G t s 0 `{ F 1 f� � , .a / ( / / t r E a,nl iF Yk"t+kikf al 'h bP �'. b l ks '•� I � tx�S K'q �g x a ''i > i I fibs <i 0 _�: Sua ai z ��#a'SiiJs3f/ 1i s4' &n r, s, yi: (� y ✓ SI'{0-h nt� s t / x, f r ti' n§h fin i.�N4 k £'�sf/ ^ s, t s)y I'll: f ?^14 t4^ yf f'� I { f ) C ryd Y l' ,1�1 k A� � >�M�f• ,rr�m` ty's �$ ebar tt k 4 n 41I � �t�Z X r iP �Is3 } i ✓ y 11 + 35{s�.y'�("f +,� tg pe s" d F �r F v s a � } a � 5 c •v• � ��. F nf,p"f s#� TY tfi rdJ ��'"s���� 'yw a,4 x-xw.+ k yxa.+Fri�d. �-praewhasFw y1.YS ZL J^w �J�.ik 4 S• 'i> a #I n hAr V9 �� �zgygfi 3 .ATE / t r � i v Pv tde C 4 + 4�3 •.� q J) f a 'sk 're rf �y rd� l u @ ? sA, tx F?ry„� 'a «ti y � F ° Q� i'r`{v r'a r A!st~52t I�r{�)�^y ,��✓rhir �,{'f}a ." 4 ^�s �# a v""'•ye '.'� {hy � w'e»t� "`+"*q,TMs i�` Z`r�n aA "m�*f R'�pu�}x�'Ill a� �{ gy�Nv��r��F�e X 77— •'' s} r I .+'�az`c n " ,'i t`nf � °"f�'y, nA" fir�'§W�'b'xWV w�,+,t} % ✓ t 'Y� � �13 n� �. � f Mee 4 � Y s4 {�I M� ��.fip��f,fN',>S4� 4�C r i ys ������3 x+ s Y i�d 'Sri FiS X 'x �+�tiv � �'�ll'a eryagalF�� � a Bi tm `F I>�,#,C }�, 4 >• � }4, t ( _ s �gk �w�dl: r�°l'It' ga• -ft i y ti "�� �d?Y.&w'£aS. 5s°_ (COPY INVOICE _ INTER-COUNTY TITLE GUARANTY AND MORTGAGE COMPANY 'ITLE NO. 127 WEST MAIN STREET-RWERHEAD, NEW YORK PARK 7.4140-FORESi a-2f fl-MOHAWK 12702-PIONEER 7-6254-WORTH 2.2445 3-136977 APPLICANT G`-2 APPLICATION DATE I F Jane 4s 1962 yTet�rry and Srnpski, Eggs. Copy of: OBJECTION ACNNDWLERGMENT Main Street DEBCRIPTiON BURL Smnthold, NewYork To: L ,; , 1 -A - TYPE OF FEE ISon`1AEE; BULK i OTHER COUNTY REISSUE AMOUNT PoL1GY 1 g 1 S U F F O L K $ 5s0000 OR SEARCH i 1 I 1 1 SIMULTANEOUS SUN 7 y OX.REPORT DATE SUN'"=' 1 None ���C iT a 189 1962 IHSDfUCRDXS ; G9 INSURE: Ronald J. 3deem � TITLE IN: Conrad Qolinaki and Jessie Volinski, as '61? K Q K Y TITLE TO BE IN: Insured A_ el��+. O(J I PREMISES: Lots: 9/Sast Marion, T/.So1 00 �yTGAGf Mep�� Blocks MapOfs BouFdee�d yyou the N a ld. oY jointly erry and partly ebTerry owned CharleslTerryMarcus Terry, on the $ z Id. of Grant E. Rackett; etc. (See attefehed dese.) FEES $ TOTAL 77*00 Plus$35.for each extra chain of title,if any. ! ! LYl<O INC..CLNYE{AXY STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION VETERANS MEMORIAL HIGHWAY HAUPPAUGE, N.Y. 11788 JAMES A. KUZLOSKI FRANKLIN E. WHITE REGIONAL DIRECTOR COMMISSIONER November 5, 1990 Mr. Ronald Edeen P.O. Box 335 Main Road East Marion, New York 11939 Dear Mr. Edeen: Our Case No. 90-343 Route 25, East Marion Your September 16, 1990 Submission As requested, we have reviewed the subject property with regard to providing access at the two existing openings through the stone wall along the site frontage. The existing breaks through the stone wall do not necessarily indicate formal access to the site although the break may have been in the past used to gain entrance to this property. At the easterly location, there is a 2 1/2 to 3 foot difference in grade between the sidewalk and the shoulder. Allowing a curb cut at this location would require extensive grading and restoration of the sidewalk and shoulder areas. We do not recommend development of a curb cut at this location. There is little evidence of an existing apron at the westerly location as you suggested. We will approve installation of a curb cut at this westerly location subject to submission of a plan showing the details of the proposed curb cut. Attached for your use is a sketch of a preferred curb cut installation for commercial property. The curb cut will be the sane but interior curbing and traffic bearing asphalt in the shoulder area will not be necessary. A 4" to 6" asphalt shoulder restoration in the area of the new curb cut will be adequate for this location. Send four copies of your plan to Mr. Vito Lena, our Regional Permit Engineer at the above address. Thank you for your cooperation in this matter. Very truly yours, DAMES 0. FREIN Civil Engineer III At to hm t JOF:JL: 9V EQUAL OPPORTUNITYIAFFIRMATIVE ACTION EMPLOYER cc: Ms. Valerie Scopaz �E4ye o���wa1/ !��rp cd/ P�tefi 114m _.tspoha Side wa/IC a�d�_rCc�c-.f y iSl.ys. `700 eoTT7�Lf//4l�G�y A�,O�Tt�PIGc9� i�IQIf/J �1�i'/Cs Y l2�.A9e/lT,J 7' C IOWA014 tG fj I/tf r 7oc7� z^ii�nT �• + G/'�S s Or �' 'I��GYG7� S• �' ,9Spjxsl�Sfxrb�er � Aspho/fcos d/.-�cri�dfjr Ft�r/lurb S�c��o•� T�ii�tt. ----�7*$ .�/e Ya lion of Or'a�o Curb uld�r- Size vs eVir'sGt�dJ t Ae Y.S. Deem Its tt i f N � Ex�n sion `/oin/ E.x��sioh ✓o�� PREFERRED ENTRY 5CHEME Aspho (t Parking Fleld in. curb,. curb 2A ' vorla �r 2O, ¢^6094W Asp aft 20 n Edge of Travel Lane S T A T E H IG H W A Y � Standard N,Y,U,T.U, Farm 8002 a 0.17.70M-3upi4 and Sda Heed With Covamut ydmt Craniar4 Acts-,Individual at Corporation(Slnoo Shen) f r CONSULT YOUR LAWYER BEFORE SIONINO THIS INSTRUMENT—THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY. LIBER 5191 PAGE 106 U.S.I,R.S $5.50 THIS INDENTURE,made the 30th day of June , nineteen hundred and sixty-two BETWEEN Conrad Volinski and Jessie B.Volinski,his wire,both residing at East Marion,New York 1 copy f party of b the first part, and Ronald Eden and Barbara J. Edeen,his wife, oth residing at East Ma Jon,New York party of the second part, WITNESSETH,that the party o e first ppart, in consi tion fien Dollar a d other valuable consideration paid by the party of the second rt, does h reby gran rel 'se unto the art of the second part, the heirs or successors and assigns of tIt arty oft cond rt oro er, M ALL that certain plot, piece o parcel o I d, Im situate, " M lying and being fn the, uni c orpo a X1 ge of Ea t Me ion, Town of Bouthold,County. of Buffo and Sta a of New Yorki, ounded and described as 'foll s-. +>> bounded on the n th by nd o former y of eorge H. Tarry ` ,rn - , •,' and partly bye la now o f'or ly owned j Intl y by Marcus Terry, Orville' Terry?,an Charle r on the ast ro o •-� , y land of' or k formerly of dr'a E. Ra a t; ou by the way and west by y,y lands now of. f,o rly o Wi Horton William H.Griffin " and the EsrBte f Geor Tuthil , eceased.-ontaining 2i .acres . more or less.'; BEING and intends be the same pre ises conveyed to the� part part deed made by He y J.Volinaki dated y of the first November 24, 1948,recorded in the S 'folk County 6lerkes office in •Liber 2 99-of—conveyances at pa e' 43S on November 291,1948- 5 1 SUBJECT to any state of facts a accurate survey might show and to zoning regulations of record, if any, t Y r� TOGETHER with all right, title and interest, if,any, of the party of the first part in and to any streets and goads abutting the above described premises to the centerlines thereof; TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second part forever., AND the party of the first part covenants that the party of the first part has not done or suffered anything =- v', .whereby the said Premises have been encumbered in any way.whatever, except as aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of 3, the first part will receive the consideration for this conveyance and will hold the right to receive such consid- eration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other. ,purpose. f The word "party" shall be construed as if it read "parties";;whenever the sense of this indenture so requires. IN WITNESS,WNEREOF,the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OR,: ' Jessie B, Volinski (L.S. ) Conrad J Volinski „ (L.S. ) - s t: On the 30th day of June 19 64 before me l ?n the day of 19 , before me personally came personally came Conrad VolinskJ and Jessie B• Vol inski to me known to be the individual described in and who to me known to be the individual described in and l who executed the foregoing instrument, and acknowledged that executed„the, foreggoing instrument, and acknowledged i that they executed the same, executed the saln�. _ Stanley S•Corwin . .,. S.TANLEY S., CORWIN NOTARY`PUBLICOSTATE OF NEW YOR RESIDING, IN,SUFFOLK COUNTY r 'CLxsl So' 52-5s264o0 I j1 COMMISSION"EXPIRES 11aroh '30vl964 STATE OF NEW "j , COUNTY O R, COUNTY OF s•s STATE OF NEW YORE, R On the ' clay of 19 before me On the " 'day of 1 19 before me personally came personally came to me known,who, being by,me,duly)sworn,did depose and the subscribing witness to the foregoing instrument, with say that _ .he.resides at No. whom I.am personally acquainted, who, being by me duly, sworn, did depose and say that he resides at No. that he is the , I j ' of that he knows r {,"' the corporation described in and which executed the foregoing instrument; that he to be the individual knows the'seal of said corporation; that the seal affixed described in and who executed the foregoing instrument; to said instrument is such corporate seal; that it was so that he, said subscribing witness, was present and saw affixed by order of the board of directors of said corpora- execute the same; and that he, said witness, tion, and that he signed h name thereto by like order, at the same time subscribed h name as witness thereto. � II t j .f N N G' 444 i T 7 3 7 a I M 1 o 0 Z .. j- _• V N I W Z 4 LL a o Recorded,„' ' 39 P.M. o t DI`� +b+ Normdn E.Klipp w ct 'Clerk of S 'f'6lk C ° og o a ''d, ,r�.? N O , i'; i p �I POLICY 12 ai..•� COPY I Owners Policy-Individual Policy No. 5-136977 Inter-County Title Guaranty and Mortgage Company I NEW YORK I Policy of Title Insurance The Inter-County Title Guaranty and Mortgage Company in consideration of the payment of its charges for examination of title and of the premium,insures RONALD J. EDEEN AND BARBARA J.EDEEN,HIS WIFE his heirs and devisees against all loss or damage not exceeding ----------------FIVE THOUSAND AND 00/100------------------------------ dollars,which the insured shall sustain by reason of any defect or defects of title affecting the premises described in Schedule "All, hereto annexed, In Witness Whereof, the INTER-COUNTY TITLE GUARANTY AND MORTGAGE COMPANY has caused e its sea corporate P 1 to be hereunto affixed and these presents to be signed b two officers this g Y of its s 30th day of June 1962. •Jean•E:Ricker• . . . • . • • • • • • INTER-COUNTY TITLE GUARANTEE AND MORTGAGE Assistant Treasurer COMPANY CORPORATE SEAL John Delag 1927 . . . . . . . . . . . . . . . . Assistant Secretary i SCHEDULE "A" 1. The estate or interest of the insured in the premises described below,covered by this policy. FEE SIMPLE 2. The description of the p property,the title of which is insured,is:- ALL that lot or parcel of land situate,lying and being in the Village of East Marion, Town of Southold,Suffolk County and 'State of New York, bounded and described as follows: BOUNDED on the North by land now or formerly of George H. Terry and partly by land now or formerly owned Jointly by Marcus Terry, Orville Terry and Charles D.Terry; On the East by land of or formerly of Grant, E.Hackett, South by the Highway; West by lands now or formerly of William O.Horton,William H. Griffin and the Estate of George Tuthill,deceased, 3. The deed or other means by which the estate or interdat covered by this policy is vested in the insured,is:- 'DEED executed by CONRAD VOLINSKI AND JESSIE B.VOLINSKI,HIS WIFE to the INSURED, dated June 30,1962 and recorded in the Office I 9f the Clark of the County of Suffolk on July 3,1962. SCHEDULE "B" The estates, interests,defeets,or objections to title, liens, charges and incumbranees affecting said premises or estate or interest insured,which do or may now exist and against which the Company does not insure or agree to indemnify are set forth in this COPY schedule. I Building restrictions and regulations contained in any resolution or ordinance( zoning resblutions) if any, adopted by the municipality in which the premises described in Schedule "A" are situated and amendments thereto. ANY state of facts a survey or any personal inspection of the insured premises might show. IN the absence of a survey,guaranteed to the Company, Company will not certify as to the location nor the dimensions of the boundary lines of the insured premises on all sides. RIGHT'S of tenants or persons, if any,in possession of the insured premises. WATER RATES,if any,not included. BOARD OF HEALTH . . . . . . . FORM NO. 1 3 SETS OF PLANS /�. . . . . . . . . . SURVEY . . I/.'. . . . . . . , TOWN OF SOUTHOLD CHECK . . .e ". . . . . . BUILDING DEPARTMENT SEPTIC FORM TOWN HALL •Pc, T SOUTHOLD, N.Y. 11971 NOTIFY : 1_ - '1 - TEL.: 765-1802 CALL .`E.77.:,�� J Examined . .� .,1.9, 19 Q Q MAIL TO : I Approved 197a. Permit No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. - INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans,accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i�ections. (Signature or a he nt, or name*, . .o: PDX 3. S LE4M1.61A ,CtV/,A r. ./1,.3F. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . .OIUA/(!Foe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . >,�� �, , .4RBA 4 C,/. L�T� 1✓ . . . (as on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ... . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land `/on which proposed work will be done: f . . . . . . . . . !!�o.-�r . . . . . f�/.�. . ./ll�.�l�. . . . . . . . . . . . . . . . . . . �57 . /�. q! 6 !4! House Number Street, PHamlet County Tax Map No. 1000 Section . . . . . . . . .. . . . . . . Block . . . , . , , , , , • 7 , , , , , Lot . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . Lot . 2 (Name . . . . . , . . . . . . . . . . . . . . . . . . . . State existing use and occupancy of premises and intended use and occupancy of proposed construction: A. Existing use and occupancy. . .V4'4;19! e.7 . . . . . . . . . . : . . . . . . . . . . . . . .•.-... . . . . . . . . . . . . . . . . . . B. Intended use and occupancy. . . .®9 ..: . . . l 8 ? , `�, • , E,ez ) It/�--• . . . . . . . . , , , I / 3. Nature of work (check which applicable): New Building . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . • Swimning pool. ... . . . Repair . . . . . . . . . . . . . . RIimoval . . . . . . . . . . . . . . Demolition 7 Tennis Court . . . . . . . . . Accssory Building . . . . . . . . . . Fence . . . . . . .Other Work. . . . . . . . . . . . 4. Estimated Cost . . . .�. ..A . . . . . . . . . . . . . . . . . Fee . . 9.(o.r. .�. . . . . . . . . . . . . . . . . . . . . . . . (to be paid on tiling this application) 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business• commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with',alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . , , , , , , , , , , , , Depth . . . . . . . . . . . . . . . . . . . . . .,Height . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . 40 . . . . . . . Rear . . . .46.p. . . . . . . . Depth Hei;lit . . . . . . . . . . . . . . .Number of Stories.. . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . ... . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation; . . . . . . . . . . . . . . . . . . . . . . . . . . 13. will lot be re raded . . . . will excess fill be removed from premises: Yes . ., , Nox 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . , . . . . . . . Address . . . . . . . . . Phone No. . . . . . . . . . . . . . . . 15 .Is this property located within 300 feet of a tidal wetland? *YES . . . .NO. . . . *If yes , Southold Townl,Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. G� STATE OF NEW YORE, S.S COUNTY OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual si.-tying contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . j . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in tite manner set forth in the application filed therewith. Sworn to before me this 9 . . . . . . . . . . . . . . . . . . . .dayof.. . .jj.��V&c.. . . . . . . . . .119l� Notary Public, . . . . . . • !+ r. •'r'•'� �• • • • • County /{/✓��iJ tiELEN K OE YOE .1 . . . . . . . . . . NOTARY PUBLIC,State of New York No.4707878.SuffolkCouniY�i (Signature of applicant) Term Expires Meech 30,19 I SUFFOLK CO. HE 1t1 FN;AtPf. I PP#2CfVAt ON i Ty ISI a N, ' . . AT STATEMENT OF #NTENT , a THE WATER SUPPLY AND SEWAGE DISPOSAL d EAST }AW . SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK tA H Eh2YICE5. } APPLICANT Z k — � to SUFFOLK ,COUNTY DEFT.. OF HEALTH" SERVICES — FOR APPROVAL -FOR_ 2 CONSTRUCTION ONLY DATE: H. S. REF. NO.: APPROVED: r SEtFFOLK EO.TAX MAP DESIGNATION,' FNST. SET. BLOCK PCL, = MG,,' (.�g�a�T. r TEST WIC1G� en at .' t `. rrs:nitbeaim8 CM 7 RK 4 2�R.: no ca shored t t.E3AM.S rt c � ��. �, -y p/yry� @,�T.QY�715! a y n h !I reap sh can .I Q✓c.�. f - � .I" �. . LLI GP w P9; to zurfel on hi u �� -tr f En T�IENT AF NEAITN SERVICES DEfAP. -. 5' �\ <9}� SUFFOLK fAUN?Y ���� �^e - `fir.. G II T�� � � � C of Fe APPROVAL OF Ream ceUntV JUL 9 g fJCL:E:I�Y2`Bfl. " �2 v'j r sc �r of IQ 4�, APPROVE YEARS FROM ATE 0 � ttE9L�-SERVI�Es. t � ��'� APPROVAL psi Yi:![2 Y JULY 2 EXPIRES TWO - 3o IM VAI�,j,�,1YL,P.C.. i +...� t sz5 a , t—ICrrEMaSEe'aw�i�LAND St1�l vEYC SWrFOLK' CO t3$AETF E E T. APPRCTVfIL h/ ^J H.S. NO. STATEt,/,ENT-OFINTEt+tT` rcea .3� , �Gc f TTHE WA:'!£R StfP-LY AND SEWAGED3MPOSA`L59. SYSTEMS FOR THIS 'RESIDENCE WILL ,>! �_ COt1FORM TO;THE STAt4bAR OF THE`UFFOLK CO. f7EPT. OF'-REALtH}5tRVICES.) APPUICA#T; wx3 t " SUFFOL3K CgUtI TY DEPT._ OF. ,ACALTH S£RVtCES, - FO.R ' APi'ROY�-A 'F©13 r' CONSTRUCT tON-(>NL:Y DATE: Y� ry ' H 5 F. NO c � APPROvVED x�2 ' Sttf F"OL►C G47'„T`AX A4�4P-"Es£�t.�NAT #1 '- . J otty,- SECT E LOCIf _ PC1 4 .: ul UJI � ��2..�YX2n3�t�_ � :OWAt�RS ADpt¢ESb t # TESS?fz.Y�f,± -LrI ' �?:>S TEST BOLE STAMP . .. .\efELi. fj .,`.tt36?.•,•�of Ea o9 Pn'2>4�QS°8 yx`aY$ _ IIIC�2PL "I'lab'3nLaw- LOAM— �n K" ,�' § h;5 y3't iinked1 ncEoai hd'vC3^.^y (.R'91fQt C inked ssa{O '{ o E r R staff auk be Csns!a'Gd .NEST?3QLE ;rahxu¢r3y. ZV' aaR thanr:son-o vh,n+h¢ - eF sRy - �; u � xnu crthsbe �f � p e _ - - CsT1AV�EL, ME'€JGtiM'TG. SEAL YEQYGQA _ NI TE E cIP � E2 Tx; P'4EA`4 �Er, rVE - ° I�;t't i�t�E�'-Jf Tv�. i i P� r�wiL4''EY v IU.Y 2 ACKL —5 t EZ II-tJ t' _ R _d is XAAi E1Xt,Ra`T� <S 256 gym;'' LICENSED LAXV St VEYOR+ l7 s ?� _,` ,•;` s/ �-3y� GREENPORT NEW.YORIK SUFFOLK CO. HEALTH DEPT. APPROVAL H. S. NO. e STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL <(', •� °-`= `, s` .- Y r.- SYSTEMS FOR THIS RESIDENCE WILL -� �0 CONFORM TO THE STANDARDS OF THE i•, whxti - --------� SUFFOLK CO. DEPT. OF HEALTH SERVICES. ' S ,an APPLICANT I r' SUFFOLK COUNTY DEPT. OF HEALTH 5• y &U-TOLKCOUNTY p SERVICES — FOR APPROVAL FOR srGLE FuLlY F.4"- .,`. oirly CONSTRUCTION ONLY DATE: �+� T7__tt SPYf"^QP. f�iS';7S&Gi <=.6 .a SUi�rr• �.iiR12S SE1f S'M7tS ��\� H. S. REF. NO "d7- f1L•t �\ APPROVED: ( � Chse E; SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. _ Lcwecz EVE, OWNERS ADDRESS: LLB —10 C TEST HOLE_ -�7 .� _• STAMP �•� -0- ° YE�5- ..JC !zed true s^*vlp a. m;, B� i� ED 17 1993 -s ----. S.C. DEPT. OF SEAL HEALTH SERVICES VERv _eats i - �JQTE " v - _ "._,t,.'mot f�.'V.,G�.�, fh-'•' - ,-.. •✓: .��; ,"�` ,l:= /P _ ..Cr� c -_ iv;c. SFr ='v"C RODERICK VAN TUYL, P.C. LICENSED LAND SURVEYORS t7 S 2 GREENPORT NEW YORK ttu�rff.on we��v r —FT1 FM _ FFPHELH - �2asY �.l��vf'"'-v�ri /�j C/✓r .C��✓5''T/c,.v "" rn, � Ny. ill 61 I 6�Ja ��✓ —_-- �..1'If6itD^.N?'If7 k'.'; i9�� p3 � =dlttrlbutlnQ al-4 MMm%PIPIeY III bi a�/rayr�2" D.AT,_, Ir l _B,r rt /J 9 S_ �� CERTIFICATE KaLonl / FEE --3 &L-o_ n,v ✓• Q_L.__. UND REQURtED o1NPN�.�.-1L h NOTIFY PIII NN' 1,. 785-1502 11 FDLLo;r�rv;, ¢r- PLUMBING - .. 3 ALL PLUMQINGWASiH OCCUPANCY OR FOR Pnu c;rrn e.;, r, &WATER LINE9 NEEp U5E I$ LG�iI�iaYl IIa 2. ROUGH - FR.-IVIW, a :_ . , .c TESTING BEFORE COVERING i a imsuu�noN WITPOU1 CERWWAT' 4 FINAL C,ONS,1,"I 1 BECONAPLI-Tr FOR ,; „ PLUAMSERCERT/F/CAVON OF OCCUPANCY Iv ALL CONSTRUCTION SHALL NIEF_T ONLEADCONTENTOEFORE - T ' F THE N Y CER THE REOIII'A6MEN S o TlF/CAT•E OF OCCUPANCY iSAll �( STATE CONSTRUCTION >y EPJERG,r SO pF ' . . MS'ri CODES. NOT RESPONSIBLE FO.. 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